Mortality after near-miss obstetric complications in Burkina Faso: medical, social and health-care factors.


Storeng, KT; Drabo, S; Ganaba, R; Sundby, J; Calvert, C; Filippi, V; (2012) Mortality after near-miss obstetric complications in Burkina Faso: medical, social and health-care factors. Bulletin of the World Health Organization, 90 (6). 418-425B. ISSN 0042-9686 DOI: 10.2471/BLT.11.094011

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Abstract

OBJECTIVE: To investigate mortality in women in Burkina Faso in the 4 years following a life-threatening near-miss obstetric complication and to identify the medical, social and health-care-related causes of death. METHODS: In total, 1014 women were recruited after hospital discharge and followed for up to 4 years: 337 had near-miss complications and 677 had uncomplicated pregnancies. Significant differences in mortality between the groups were assessed using Fisher's exact test. The medical causes of death were identified from medical records and verbal autopsy data; social and health-care-related factors associated with death were identified from interviews with the deceased women's relatives. FINDINGS: In the 4 years, 15 (5.3%) women died in the near-miss group and 5 (0.9%) died after uncomplicated pregnancies (P < 0.001). More than half the deaths after a near miss, but none after an uncomplicated delivery, were pregnancy-related. Indirect factors contributed to many of these deaths, particularly human immunodeficiency virus infection. Relatives' accounts suggested that the high cost and poor quality of health care, a lack of follow-up care and an unmet need for contraception contributed to the excess mortality in the near-miss group. CONCLUSION: Women in Burkina Faso who initially survived a near-miss obstetric complication had an increased risk of all-cause and pregnancy-related death in the ensuing 4 years. The likelihood of survival over the longer term could be increased by offering a continuum of care that addresses the indirect and social causes of death and supplements the emergency intrapartum obstetric care provided by current safe motherhood programmes.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Maternal, Reproductive and Child Health (MARCH)
Maternal Health Group
Population Studies Group
PubMed ID: 22690031
Web of Science ID: 305168900015
URI: http://researchonline.lshtm.ac.uk/id/eprint/146736

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